Wound dressings and airborne dispersal of bacteria

Lawrence, J.C.; Lilly, H. A.; Kidson, A.

doi:10.1016/0140-6736(92)91931-w

Cited by 40 publications

(18 citation statements)

References 1 publication

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“…17,29 As the name implies, wet-to-dry dressings ultimately result in dry wound beds (even if for limited amounts of time), and the practice of using them is no longer evidence based. 2 -4,9,10,13,14,18,19,22,23,30 -34 The scientific literature reports that dry gauze dressings in open wounds (whether used dry or used as wet-to-dry) disrupt granulating tissue, 3 impair epithelial cell migration and histological activity, 9,14,23 leave foreign bodies in the wound bed, 14 increase the risk of infection, aerosolize bacteria, 14,22,35 cause severe pain upon removal, 24,36 and are less effective and more costly than other forms of debridement such as collagenase, fibrinolysin, and autolysis. 25,26,37 To reiterate, wetto-dry dressings are used primarily for mechanical debridement, and they are not described in any current scientific literature as having another purpose.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Wet-to-Dry Dressings in Wound Care

Cowan

Stechmiller

2009

Advances in Skin &Amp; Wound Care

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These findings suggest that wet-to-dry dressings (or dry gauze) are prescribed inappropriately in situations where there is little evidence to support their use. To achieve evidence-based practice in wound care, clinical decision making should be scientifically based. Future research should focus on which wound dressings are most effective in optimizing wound healing, as well as on investigating the reasons for the continued use of wet-to-dry dressings.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Wet-to-Dry Dressings in Wound Care

Cowan

Stechmiller

2009

Advances in Skin &Amp; Wound Care

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“…In this study, both the hydrofibre and central pad dressings performed well in terms of ease of application/removal and patient comfort; however, amongst patients in the hydrofibre group, the mean number of times that dressings required changing prior to five postoperative days was significantly reduced. This has two main effects: firstly, less nursing time is required; and secondly, because the dressing is disturbed less often, this aids the healing process by reducing the risk of infection (11).…”

Section: Discussionmentioning

confidence: 99%

The management of wounds following primary lower limb arthroplasty: a prospective, randomised study comparing hydrofibre and central pad dressings

Abuzakuk

Coward

Shenava

et al. 2006

International Wound Journal

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Wound care following lower limb arthroplasty has not been subject to in-depth clinical research, primarily because such wounds usually heal without complication. However, when prosthetic implants are used, serious wound problems can be disastrous (Whitehouse et al. Infect Control Hosp Epidemiol 2002;23:183-9; Lindwell OM. Clin Orthop Relat Res 1986;211:91-103). We report the results of a prospective, randomised, controlled trial comparing a hydrofibre (Aquacel) and central pad (Mepore) dressing in the management of acute wounds following primary total hip or knee arthroplasty left to heal by primary intention. Dressing performance was measured in 61 patients receiving total hip or knee replacements. There was a significant reduction in the requirement for dressing changes before five postoperative days in the hydrofibre group (43% compared with 77% in the central pad group), and there were fewer blisters amongst patients in the hydrofibre group (13% compared with 26% in the central pad group). We conclude that there is a potential role for hydrofibre dressing in the management of arthroplasty wounds.

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“…Although contact is well-accepted as a means of transmission of nosocomial infection, concepts of airborne transmission of hospital infection are evolving. 29,30 Early studies showed that all airborne and dry-surface microbes undergo desiccation; however, often overlooked were the genetic repair and secondary rehydration with ambient humidity that virtually ensure spread of disease by the aerobiological pathway. 22 Many microbes have the capability of remaining airborne and viable, or settling and re-suspending for extended periods in the indoor environment, 31 and may exist as single cells or spores, aggregates or as biological material carried by non-biological particles.…”

Section: Discussionmentioning

confidence: 99%

Effect of enhanced ultraviolet germicidal irradiation in the heating ventilation and air conditioning system on ventilator-associated pneumonia in a neonatal intensive care unit

et al. 2011

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Objective: The objective of this study was to test the hypothesis that enhanced ultraviolet germicidal irradiation (eUVGI) installed in our neonatal intensive care unit (NICU) heating ventilation and air conditioning system (HVAC) would decrease HVAC and NICU environment microbes, tracheal colonization and ventilator-associated pneumonia (VAP).Study Design: The study was designed as a prospective interventional pre-and post-single-center study. University-affiliated Regional Perinatal Center NICU. Intubated patients in the NICU were evaluated for colonization, and a high-risk sub-population of infants <30 weeks gestation ventilated for X14 days was studied for VAP. eUVGI was installed in the NICU's remote HVACs. The HVACs, NICU environment and intubated patients' tracheas were cultured pre-and post-eUVGI for 12 months. The high-risk patients were studied for VAP (positive bacterial tracheal culture, increased ventilator support, worsening chest radiograph and X7 days of antibiotics).Result: Pseudomonas, Klebsiella, Serratia, Acinetobacter, Staphylococcus aureus and Coagulase-negative Staphylococcus species were cultured from all sites. eUVGI significantly decreased HVAC organisms (baseline 500 000 CFU cm À2 ; P ¼ 0.015) and NICU environmental microbes (P<0.0001). Tracheal microbial loads decreased 45% (P ¼ 0.004), and fewer patients became colonized. VAP in the highrisk cohort fell from 74% (n ¼ 31) to 39% (n ¼ 18), P ¼ 0.04. VAP episodes per patient decreased (Control: 1.2 to eUVGI: 0.4; P ¼ 0.004), and antibiotic usage was 62% less (P ¼ 0.013).Conclusion: eUVGI decreased HVAC microbial colonization and was associated with reduced NICU environment and tracheal microbial colonization. Significant reductions in VAP and antibiotic use were also associated with eUVGI in this single-center study. Large randomized multicenter trials are needed.

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Wound dressings and airborne dispersal of bacteria

Cited by 40 publications

References 1 publication

Prevalence of Wet-to-Dry Dressings in Wound Care

Prevalence of Wet-to-Dry Dressings in Wound Care

The management of wounds following primary lower limb arthroplasty: a prospective, randomised study comparing hydrofibre and central pad dressings

Effect of enhanced ultraviolet germicidal irradiation in the heating ventilation and air conditioning system on ventilator-associated pneumonia in a neonatal intensive care unit

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